<link href="{$base_dir}css/print.css" type='text/css' rel='stylesheet'/>

<div style="width: 17cm; font-size: 14px;">
    <table width="100%">
        <tr>
            <td align="center" style="padding-left: 4cm;padding-right: 4cm;">
                <span class="printHeader">{translate}Medicine receive form{/translate}</span>
            </td>
        </tr>
    </table>
    <p>{$hospitalManage}</p>
    <p>{$hospitalName}</p>
    <p>{translate}Department{/translate}&nbsp;{$deptName}</p>
    <table width="100%" cellspacing="0" cellpadding="0" class='printGrid2'>
        <tr>
            <th class="first">{translate}Order number{/translate}</th>            
            <th>{translate}Medicine name_content{/translate}</th>
            <th>{translate}Quantity title{/translate}</th>
            <th>{translate}Require number{/translate}</th>
            <th>{translate}Issue number{/translate}</th>
            <th class="last">{translate}Note{/translate}</th>
        </tr>
        {foreach from=$printedRowList item=row}
           <tr>
               <td class="first">{$row.index}</td>
               <td>{$row.medicine_name}</td>
               <td>{$row.quantity_title}</td>
               <td>{$row.requirement_num}</td>
               <td>&nbsp;</td>
               <td>&nbsp;</td>
           </tr>
        {/foreach}
    </table>
    <p align="right">
        {translate}Day{/translate}.......{translate}Month{/translate}.......{translate}Year{/translate}.......
    </p>
    <table width="100%">
        <tr>
            <td width="25%" align="center"><span style="text-transform: uppercase;font-weight: bold;">{translate}Medical Dept. Chief{/translate}</span></td>
            <td width="25%" align="center"><span style="text-transform: uppercase;font-weight: bold;">{translate}Issue person{/translate}</span></td>
            <td width="25%" align="center"><span style="text-transform: uppercase;font-weight: bold;">{translate}Receiver{/translate}</span></td>
            <td width="25%" align="center"><span style="text-transform: uppercase;font-weight: bold;">{translate}Department Chief{/translate}</span></td>
        </tr>
    </table>
</div>